High prevalence of Streptococcus pneumoniae with mutations in pbp1a, pbp2x, and pbp2b genes of penicillin-binding proteins in the nasopharynx in children in Japan
High prevalence of Streptococcus pneumoniae with mutations in pbp1a, pbp2x, and pbp2b genes of penicillin-binding proteins in the nasopharynx in children in Japan
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DOI：
10.1159/000091276
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发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Yamanaka, N
中科院分区：
文献类型：
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作者：
Hotomi, M;Billal, DS;Yamanaka, N
目的：评价肺炎链球菌对β-内酰胺类抗生素的耐药性，该耐药性是通过逐步改变高分子量青霉素结合蛋白（PBP）与β-内酰胺类抗生素的结合亲和力降低而产生的。在改变β-内酰胺类亲和力的pbp基因中的众多突变中，PBP 1A、2X和2B的亲和力降低在β-内酰胺类抗性的发展中尤其重要。研究设计：回顾性审查。研究方法：在这项研究中，我们调查的突变pbp 1a，pbp 2x和pbp 2b基因聚合酶链反应（PCR）的866例肺炎球菌分离株从日本儿童急性中耳炎的鼻咽部。结果：210株（24.3%）pbp基因无突变。333株（38.5%）有3个pbp基因突变，78株（9.0%）有2个pbp基因突变，245株（28.3%）有1个pbp基因突变。在656株pbp基因突变的菌株中，620株（94.5%）存在pbp 2x突变。耐药沙门氏菌的年流行率。肺炎杆菌中三个PBP基因突变的菌株逐渐增加，而没有突变的菌株平行减少。结论：基于PCR的基因分型方法可以沿着最小抑菌浓度（MIC）来表征肺炎球菌的耐药性。临床医师应注意近期耐药链球菌的增加。肺炎，治疗小儿急性中耳炎。版权所有（c）2006 S. Karger AG，巴塞尔。
Objective: To evaluate the resistances of Streptococcus pneumoniae to beta-lactams developed by stepwise alterations in high-molecular-weight penicillin-binding proteins (PBPs) with a reduced binding affinity of beta-lactams. Among the numerous mutations in pbp genes that alter the affinity for beta-lactams, the decreased affinity of PBP1A, 2X and 2B is especially important in the development of resistances to beta-lactams. Study Design: Retrospective review. Methods: In this study, we investigated the mutations in pbp1a, pbp2x, and pbp2b genes evaluated by polymerase chain reaction (PCR) in 866 pneumococcal isolates collected from the nasopharynx of Japanese children with acute otitis media. Results: 210 strains (24.3%) exhibited no mutations in the three pbp genes. 333 strains (38.5%) had mutations in the three pbp genes, 78 (9.0%) in two pbp genes, whereas 245 (28.3%) displayed mutations in only one pbp gene. Among the 656 strains with mutations in pbp genes, 620 (94.5%) strains had mutations in pbp2x. The annual prevalence of antimicrobial-resistant S. pneumoniae showed a gradual increase in strains with mutations in the three pbp genes and a parallel decrease in strains without mutations. Conclusions: PCR-based genotyping can characterize the antimicrobial resistances in pneumococci along with minimal inhibitory concentrations (MICs). Physicians should pay attention to the recent increase in antimicrobial-resistant S. pneumoniae when treating pediatric acute otitis media. Copyright (c) 2006 S. Karger AG, Basel.